Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223P0106X | Oral and Maxillofacial Pathology | 30017635 | OH |
NPI | 1992733174 |
---|---|
Provider Name | Dr. Patrick Allan Chaney |
First Address | Lima, OH 45801-3971 |
Second Address | Lima, OH 45801-3971 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 28/06/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0704689 | (05) | OH |